Anterior Process of the Calcaeous Fracture
synonyms:
Anterior Process Calcaneous ICD-9
- 825.0(closed), 825.1(open)
Anterior Process Calcaneous Etiology / Epidemiology / Natural History
Anterior Process Calcaneous Anatomy
Anterior Process Calcaneous Clinical Evaluation
- Tenderness in an area approximately 2 cm anterior and 1 cm inferior to the anterior talofibular ligament indicates anterior calcaneal process fracture
- Swelling and ecchymosis anterior and inferior to the anterior talofibular ligament indicates anterior calcaneal process fracture.
Anterior Process Calcaneous Xray / Diagnositc Tests
- Difficult to visualize on standard xrays
- Consider oblique lateral radiograph directing the beam 20° superior and posterior to the midportion of the foot to visualization of the fracture.
- CT with 1mm cuts allows accurate assessment of hindfoot fractures and is indicated for patients with clinical suspision of a hindfoot fracture and negative xrays.
Anterior Process Calcaneous Classification / Treatment
- Acute Non-displaced (<1cm in size or <2mm displaced or <25% of calcaneal-cuboid articulation involvement):short-leg, non-weight bearing cast for 6 weeks. Advance to wbat in removable cam-walker if asymptomatic at 6weeks. (Degan TJ, JBJS 1982;64A:519)
- Noncomminuted, Displaced (>1cm in size or >2mm displaced): ORIF with small or mini-fragment screws or k-wires. It is rare to find an anterior process calcaneal fx large enough to warrant ORIF.
- Comminuted, Displaced: Primary excision
- Chronic injuries generally have poor outcomes with non-surgical management and fragment excision for small non-articular fragments or ORIF for large articular fragments should be consider.
Anterior Process Calcaneous Associated Injuries / Differential Diagnosis
Anterior Process Calcaneous Complications
Anterior Process Calcaneous Follow-up Care
Anterior Process Calcaneous Review References
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